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108 Cards in this Set

  • Front
  • Back
four portals of entry of toxic exposure
surface absorption
most common route of entry for toxic exposure
a poison that is easily absorbed through the skin
Antidote for acetaminophen
N- Acetylcysteine
Antidote for Atropine
Physostigmine (also known as eserine) is a parasympathomimetic, specifically, a reversible cholinesterase inhibitor
Antidote for Benzodiazepines
Antidote for Carbon monoxide
Antidote for Cyanide
Amyl nitrate
Sodium nitrite
sodium thiosulfate
Antidote for Methyl alcohol
ethyl alcohol
Antidote for Nitrates
methylene blue
Antidote for Opiates
Antidote for Organophosphates
symptoms of cyanide poison
cellular asphyxiant
burning sensation in mouth
H/A confusion, combative
Hypertension and tachy
Seizures and coma
Pulmonary edema
how do nitrites remove cyanide from the blood
converts some hemaglobin to methemoglobin and cyanide binds to it, Thiosulfate then binds with cyanide and deactivates it
what would multiple patients living together ina apoorly heated and vented space having flulike symptoms alert you to
Carbon Monoxide poisoning
Symptoms of CO poisoning
altered LOC
symptoms of cardiac medication OD
H/A pulmonary edema
bradycardia / heart blocks
antidote for calcium channel blockers
antidote for beta blockers
antidote for digoxin
what is the PH of strong acids
less then 2
what is the PH of strong alkaline agents
common forms of alkaline and acid agents
Drano or Luquid plumber
Describe a strong acid burn
produces immidiate and severe pain
results in tissue coagulation and necrosis
which acts like a shield to stop burning
Describe a strong Alkaline burn
pain is oftern delayed
they produce Liquefaction necrosis which causes deep burns
symptoms of caustic injury
facial burns
pain in the lips tongue throat or gums
drooling, trouble swollowing
hoarseness, stridor or shortness of breath
Will Acids or Alkalis absorb
activated charcoal
NO!! so dont give it
rapid transport...
what is Hydrofluoric acid used for
glass etching
what is special about hydrofluoric acid
it is extremely toxic and can be lethal despite the appearance of only moderate burns to the skin death has been reported from <2.5 BSA
What will inactivate hydrofluoric acid and why is that bad
cations such as calcium which is leeched out of bones and causes total disruption of cell function
symptoms of hydrofluoric acid exposure
burning at the site
trouble breathing
muscle cramps
what special treatments would be good for hydrofluoric acid
irrigate the affected area
Immerse the affected limb in iced water with magnesium sulfate, calcium salts, benzethonium chloride
treatments for injestion of hydrocarbons
gastric lavage can be useful
Symptoms of Tricyclic Antidepressants
dry mouth, blurred vision
Urinary retention, Constipation, Confusion, Hyperthermia, Respiratory depression, Seizures,Tachycardia and hypotension, HEART BLOCK, WIDE QRS TORSADE DE POINTES
what are the most common cause of death in tricyclic antidepressants
cardiac dysrhthmias
If you had a benzodiazapine overdose mixed with tricyclic antidepressants would you use Flumazenil
NO it could cause seizures
What could be a good treatment for tricyclic antidepresants
sodium bicarbonate
What do MAO inhibitors do
they inhibit the breakdown of neurotransmitters such as epi and dopamine and increase the availability of components needed to make even more neurotransmitters
Symptoms of MAO inhibitors
H/A, agitation, restlessness, tremor
Nausea, palpitations, tachycardia, hypertension, hyperthermia, then coma
What is the antidote for MAO inhibitors
just treat the S/S
What kind of drugs are
these are selective serotonin reuptake inhibitors
what is Lithium used for
treatment of bibolar disorder
Symptoms of Lithium O/D
thirst/ dry mouth
tremor/muscle twitching/N/V
bradycardia and dysrhythmias
Will activated charcoal bind to Lithium
NO !!
but sodium bicarb may be an option, dialysis is usually needed
what are Salicylates
this is ASPIRIN
What do salicylates do to the body
they inhibit normal energy production and acid buffering ing th body resulting in metabolic acidosis
How much salicylates is neede to cause toxicity
300 mg/kg
what would the appropriate treatment be for Salicylates overdose
Activated charcoal
IV wide full Open
sodium bicarbonate for urine alkalinization
at what range is acetaminophen toxic
150 mg/kg
treatment for acetaminophen
mucomyst but usually given on clinical an laboratory studies
when can injestion of iron become toxic
can activated charcoal be used in iron overdose
treatments for iron overdose
gastric lavage is an option
and Deferoxamine binds to iron so that less is taken up by the cells
what is exotoxin
a soluble poisonous substance secreted during growht of bacterium
what is a enterotoxin
an exotoxin that produces gastrointestinal symptoms and diseases such as food poisoning
what is Clostridium botulinum
this is the worlds most toxic poison in food
symptoms of food poisoning
N/V diarrhea
abdominal pain
facial flushing
What are two deadly mushrooms
Amanita and Galerina these belong to the deadly cyclopeptide
what is the mortality rate of eating deadly mushrooms
about 50%
symptoms of poisonous plang ingestion include what
excessive salivation, lacrimation, diaphoresis, abdominal cramps, N/V diarrhea, decreased LOC, coma
what are hymenoptera
wasps, bees, hornets and ants
what appears after a bite of a brown recluse spider whith in minutes
small erythematous macule surrounded by a white ring forms
what are the symptoms of a brown recluse spider over 8 hours
localized pain, redness and swelling develop
tissue necrosis, chills, fever, nausea nd vomiting and joint pain. AND DIC
what is Disseminated intravascular coagulation
this is a bleeding disorder when blood starts to coagulate throughout the whole body, which depletes the body of platlets and coagulation factors which will increase the risk of hemorage
what does the black widow spider look like
orange hourglass marking on her black abdomen
what does the venom of the black widow spider cause
excessive neurotransmitter release at the synaptic junctions
Symptoms of a black widow spider bite
pain and redness and swelling
muscle spasms of all large muscle groups, siezures, paralysis and decreased LOC
what are a couple of good treatments for a black widow spider bite
Diazepam 2.5-10mg IV
Calcium gluconate 0.1/kg of 10% IV solution
what kind of scorpion can kill you
the bark scorpion
Symptoms of a scorpions attack
acts on the nervous system producing a burnign and tingling effect without much evidence of injury initially
progresses to numbness, slurred speech,twitching,
treatments for scorpions attack
constricting band no tighter than a watchband,
Do not use analgesics
what are the two family of snakes found in the US
Pit vipers and
coral snakes
name some common pit vipers
describe a corral snake
it is a small snake
round eyes and narrow head and not pit
has yellow banded red and black rings around its body
what is the mnemonic used to determine lethal coral snakes
red touch yellow kill a fellow
red touch black venom lack
what does the bite of a pit viper do to you
venom contains hydrolytic enzymes that destroy proteins
this may affect the blood clotting system and produce necrosis
what can a severe pit viper bite result in
death from shock in 30 min
but most deaths occure within
48 hours 90% anyway
what is the snake bite treatment for a pit viper
keep patient supine
immobilize the limb
maintain the extremity in a neutral position
O2 and fluid
what will a coral snake bite result in
its neurotoxin primarily effects the neruo tissue which results in respiratory and skelital muscle paralysis
what is the treatment for a coral snake bite
wash the wound with copious amounts of water and apply a compression bandage and keep the extremity at the level of the heart
imobolize O2 and IV
describe the poisonous toxins of marine animals
they are ustable and heat sensitive, heat will relieve the pain and inactivate the venom.
what is a huge consideration with marine animal attacks in the water
both fresh water and salt water containg a huge bacterial and viral population beware of maring aquired infections
drug overdose refers to what
poisoning from a pharmacological substance in excess of that usually prescribed or that the body cna tolerate
Benzodiazepines are used to treat what common drugs that are abused
what do you do for a benzodiazepine over dose
alcohol over dose may require what
Thiamine and D50W for hypoglycemia
Alcohol causes what
CNS depression and slurred speech
barbiturates cause what
respiratory depression and slurred speech
Cocaine causes what
Dialated pupils
Chest pain
Narcotics such as heroin and codeine cause
CNS depression
Constricted pupils
respiratory depressoin
marijuana causes what
dry mouth
Dilated pupils
Amphetamines cause what
Dilated pupils
Hallucinogens like LSD and PCP cause what
Psychosis and Dilated pupils
and hallucinations
Sedatives like valium cause what
Altered mental status adn hypotension
respiratory depression
benzodiazepines cause what
Altered mental status
slurrd speech
what is the most common substance of abuse in the us
how many poisonings occur annually
4 million
what is the most common route of entry for toxic exposure
In cases of poisoning a patient history is hard to obtain because of what
deliberate deception
patient misinformation
drug induced confusion
describe the epidemiology of toxic emergencys
The frequency of toxicological emergencies continues to increase
70% of acccidental poisonings occur among children 6 or younger
serious poisonings in older children may represent intentianil poisoning
Adult poisonings and OD account for 95% of fatalities in this category
In a toxic emergency should you delay transport or support to call poison control
What is the most common route for a toxic substance
What are the 3 principles of decontamination
reduction of intake of toxin into the body
reduction of absorption of toxin already in the body
Increase in elimination of toxin from the body
In a toxicological emergency
the physical exam has what two purposes
documenting physical evidence of intoxication
detect any underlying illness or condition that might affect either patients symptoms or outcome of exposure
what are the typical signs an symptoms of carbon monoxide poisoning
nausea and vomiting
confusion ans altered mental status
an external pacing device may be needed for what kind of overdose
cardiac medication
Describe MAO inhibitors
treat depression
narrrow index
do not eat cheese and wine
s/s may appear late in od
Describe DTs
develope 2 or 3 days after the last drink
decreased loc with hallucinations
Do not occure with binge drinking